DRUG STUDY

Name of Class Indication Mechanism of Action Contraindication Special Precaution Nurse’s

Drug Responsibilities

Tramadol Analgesi Moderate  decreases pain  Hypersensitivity  Pregnancy  Advice patient to

(Tramal, c to  binds to mu-opioid  Acute intoxication  Lactation (excreted in avoid alcohol and
Ultram) severe receptors with alcohol, breast milk) OTC medication
pain  inhibits reuptake of hypnotics, central-  Not recommended for w/o medical
serotonin and acting analgesics, children <16 yrs. And advice
norepinephrine in the opioids, psychotropic elderly >75 yrs (less  Increase intake of
CNS. agents ability to tolerate side fluids and bulk
effects) with laxatives to
 Renal impairments minimize
 Cirrhosis constipating
effects.
 Encourage patient
to cough and deep
breathe q2 to
prevent atelactasis
and pneumonia.
 Overdose may
cause respiratory
depression and
seizures. Naloxone
(Narcan) may
reverse some, but
not allsymptoms
of overdose
 Instruct patient to
change position
slowly to prevent
orthostatic
hypotension
 Instruct patients to
monitor for and
report occurrence
of drug-induced
adverse reaction

Name of Class Indication Mechanism of Contraindication Special Precaution Nurse’s Responsibilities

 Drug Action

Ranitidin  Histamin  Treatment  Inhibits the  Hypersensitivity,  Pregnancy  Instruct patient not to take
e e H2 and action of Cross-sensitivity  Lactation new medication w/o
(Zantac) antagonis prevention histamine at the may occur; some (excreted in consulting physician
t of H2 receptor site oral liquids breast milk)  Instruct patient to take as
 Anti- heartburn, located contain alcohol  Geriatric patients directed and do not increase
ulcer acid primarily in and should be (more dose
indigestion, gastric parietal avoided in patients susceptible to  Allow 1 hour between any
and sour cells, resulting with known adverse CNS other antacid and ranitidine
stomach. in inhibition of intolerance reactions)  Avoid excessive alcohol
 Prophylaxi gastric acid  Renal  Assess patient for epigastric
s of GI secretion impairments or abdominal pain and frank
hemorrhage  has some  Cirrhosis or occult blood in the stool,
from stress antibacterial emesis, or gastric aspirate
ulceration action against  Nurse should know that it
H. pylori may cause false-positive
results for urine protein; test
with sulfosalicylic acid
 Inform patient that it may
cause drowsiness or dizziness
 Inform patient that increased
fluid and fiber intake may
minimize constipation
 Advise patient to report onset
of black, tarry stools; fever,
sore throat; diarrhea;
dizziness; rash; confusion; or
hallucinations to health car
professional promptly
 Inform patient that medication
may temporarily cause stools
and tongue to appear gray
black
 Instruct patients to monitor
for and report occurrence of
drug-induced adverse reaction
 Name of Drug Class Indication Mechanism of Contraindication Special Precaution Nurse’s Responsibilities
Action
 `Assess patient for infection (vital
Ampisulbactam Anti- Treatment of  Bactericidal  Contraindicated  Allergies signs, wound appearance, sputum,
(Unasyn) infectives respiratory action against in individuals (especially to urine, stool, and WBCs) at
infections beta-lactamase- with a history penicillin or beginning and throughout therapy.
producing of other  Obtain a history before initiating
strains: hypersensitivity antibiotics). therapy to determine previous use
Streptococci, to any of the Prolonged use of and reactions to penicillins or
Penumococci, penicillins. may result in a cephalosporins. Negative history
Enterococci, secondary of penicillin sensitivity may still
Haemophilus infection (e.g., have an allergic response.
influenzae, oral, bladder or  Obtain specimens for culture and
 Binds to vaginal yeast sensitivity before therapy. First
bacteria cell infection). dose may be given before
wall, resulting  Contains receiving results.
in cell death, sodium. This  Observe patients for signs and
spectrum is could affect you symptoms of anaphylaxis (rash,
broader than if you are on a pruritus, laryngeal edema,
that of salt-restricted wheezing). Discontinue the drug
penicillin. diet. and notify the physician
 Addition of  Lactating. immediately if these occur. Keep
sulbactam Small amounts epinephrine, antihistamine, and
increases are found in resuscitation equipment close by
resistance to breast milk. in the event of an anaphylactic
beta-lactamase, reaction.
enzymes  Caution patient to notify
produced by physician if fever and diarrhea
bacteria that occur, especially if stool contains
may inactivate blood, pus, or mucus.
ampicillin.  Advise patient not to treat
diarrhea without consulting health
care professional. May occur up
to several weeks after
discontinuation of medication.
 Instruct patient to notify physician
if symptoms do not improve.

Name of Drug Class Indication Mechanism of Action Contraindication Special Precaution Nurse’s Responsibilities
Metronidazol Anti- Amebicide  Disrupts DNA and Hypersensitivity  Pregnancy (should be  Administer with food or
e protozoals in the protein synthesis in avoided during the milk to minimize GI
(Flagyl) Anti- managemen susceptible organisms 1st trimester because irritation. Tablets may be
infectives t of amebic  Bactericidal, or mutagenicity is a crushed for patients with
dysentery amebicidal action concern.) difficulty swallowing.
 Lactation (excreted in  Instruct patient to take
breast milk) medication as directed,
evenly spaced between
dose. Do not skip doses or
double up on missed doses.
 May cause dizziness or
light-headedness. Caution
patient on activities
requiring alertness until
response to medication is
known.
 Inform patient that
medication may cause an
unpleasant metallic taste.
 Inform patient that
medication may cause
urine to turn dark.
 Advise patient to consult
health care professional if
no improvement in a few
days or if signs and
symptoms of
superinfection (black furry
overgrowth on tongue;
loose or foul-smelling
stools develop).
 Instruct patients to monitor
for and report occurrence
of drug-induced adverse
reaction

Name of Drug Class Indication Mechanism of Contraindication Special Precaution Nurse’s Responsibilities
Action
Diclofenac NSAIDS  Mild to  Inhibits  Hypersensitivity  Pregnancy (may  Obtain history of patient’s
(Cataflam) moderate cyclooxygenase, to aspirin and cause miscarriage) underlying condition
pain enzyme needed NSAIDS  If you are having before therapy
 Fever for  IV administration surgery, including  Administer with food or
 Inflammat prostaglandin is contraindicated dental surgery, tell milk to minimize GI
ion synthesis, with renal the doctor or dentist irritation. Take with full
resulting to impairment, that you are taking glass of water to enhance
analgesic, hypovolemia, or diclofenac absorption.
antipyretic, anti- dehydration  Administer with patient
inflammatory  History of recumbent or tilting head
effects. bleeding back
 Do not crush or chew drug
 Teach patient to report any
sign and symptom of GI
bleeding, bleeding,
bruising
 Advise patient to report
flu-like symptoms, nausea,
vominting, jaundice,
pruritus
 Advice patient to avoid
aspirin and NSAIDS
 Avoid alcoholic beverage
 Instruct patient to avoid
use during pregnancy.
 Instruct patients to monitor
for and report occurrence
of drug-induced adverse
reaction

Name of Class Indication Mechanism of Contraindication Special Precaution Nurse’s Responsibilities

 Drug Action

Tranexamic Hemostatic  Short-term  Inhibits  Hypersensitivity  Pregnancy and  Assess patient history on
Acid management breakdown of  Severe renal lactation intravascular clotting,
(Hemostan) of fibrin clots insufficiency  Monitor closely in hemorrhage
hemorrhage  Blocks  Patients with disseminated  Obtain prothrombin time
 Treatment binding of microscopic intravascular of patient
and plasminogen hematuria coagulation.  May be mixed with most
prophylaxis and plasmin to  Mild to moderate solution, not with
of fibrin renal impairment, penicillin
hemorrhage irregular menstrual  Advise patient about
associated bleeding, previous possibility of skin reaction
with history of (rash, blisters)
excessive thromboembolic  Advise patient to report
firbinolysis disease, hematuria visual abnormalities
 Instruct patients to monitor
for and report occurrence
of drug-induced adverse
reaction